肾素-血管紧张素-醛固酮系统在介导 COVID-19 病理生理学中的作用。
Role of the RAAS in mediating the pathophysiology of COVID-19.
机构信息
Department of Cardiology, Regional Specialist Hospital in Wrocław, Kamieńskiego 73a, Wrocław, 51-124, Poland.
Department of Cardiology, 4th Military Hospital, Faculty of Medicine, Wroclaw University of Science and Technology, Weigla 5, Wrocław, 50-981, Poland.
出版信息
Pharmacol Rep. 2024 Jun;76(3):475-486. doi: 10.1007/s43440-024-00596-3. Epub 2024 Apr 23.
The renin-angiotensin-aldosterone system (RAAS) holds a position of paramount importance as enzymatic and endocrine homeostatic regulator concerning the water-electrolyte and acid-base balance. Nevertheless, its intricacy is influenced by the presence of various complementary angiotensins and their specific receptors, thereby modifying the primary RAAS actions. Angiotensin-converting enzyme 2 (ACE2) acts as a surface receptor for SARS-CoV-2, establishing an essential connection between RAAS and COVID-19 infection. Despite the recurring exploration of the RAAS impact on the trajectory of COVID-19 along with the successful resolution of many inquiries, its complete role in the genesis of delayed consequences encompassing long COVID and cardiovascular thrombotic outcomes during the post-COVID phase as well as post-vaccination, remains not fully comprehended. Particularly noteworthy is the involvement of the RAAS in the molecular mechanisms underpinning procoagulant processes throughout COVID-19. These processes significantly contribute to the pathogenesis of organ complications as well as determine clinical outcomes and are discussed in this manuscript.
肾素-血管紧张素-醛固酮系统(RAAS)作为水-电解质和酸碱平衡的酶和内分泌稳态调节剂,具有至关重要的地位。然而,其复杂性受到各种互补血管紧张素和其特定受体的影响,从而改变了主要 RAAS 作用。血管紧张素转换酶 2(ACE2)是 SARS-CoV-2 的表面受体,在 RAAS 和 COVID-19 感染之间建立了重要联系。尽管反复探讨了 RAAS 对 COVID-19 病程的影响,并成功解答了许多疑问,但它在 COVID-19 后阶段包括长 COVID 和心血管血栓形成结果以及疫苗接种后延迟后果的发生机制中的完全作用仍未完全理解。特别值得注意的是,RAAS 参与了 COVID-19 中促凝过程的分子机制。这些过程对器官并发症的发病机制有重大影响,并决定了临床结果,本文对此进行了讨论。
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